Botulism (cont.)

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What are complications from botulism?

Botulism can result in death from respiratory failure. In the past 50 years, the rate of death from botulism has fallen significantly. Unfortunately, to survive, a patient with severe botulism may require not only a breathing machine but also intensive medical and nursing care for several months.

Patients who survive an episode of botulism poisoning may experience fatigue and shortness of breath for years, and long-term therapy may be needed to aid recovery.

In 2009, the FDA increased its label precautions on the three available products: BOTOX, Dysport, and Myobloc. All three are different formulations of the toxin and are not interchangeable with regard to dosing. In addition, the FDA cautions that all the symptoms of botulism can occur if the treatments are inappropriately given, especially in high doses or if some of the solution seeps out of the localized area where it is injected. The FDA further warned care providers that suppliers of medical toxins that do not have FDA approval may supply faulty products that could harm individuals.

What is the prognosis (outcome) of people with botulism?

Untreated botulism has a mortality rate (death rate) of about 50%. Appropriately treated patients with botulism currently still have a mortality rate of about 3%-5%. Some patients may experience various degrees of paralysis for many months. In general, the earlier the diagnosis and treatment of the disease, the better is the prognosis. However, outcomes may be considered only fair in some patients who develop chronic fatigue and shortness of breath for many years after the initial diagnosis and treatment of botulism.